A nurse is caring for a client following an involuntary admission to'an acute mental health facility. The client states, "I'm afraid they will give me drugs that put me to sleep." Which of the following statements should the nurse make?
"You will need to rest so that you can recover from the episode that brought you here."
"I will make sure that we respect your right to refuse medications.
"It's not your choice to be here, so you have to accept the treatment we plan for you."
"Why do you think your provider will prescribe you medications that will make you sleep?"
The Correct Answer is B
A. "You will need to rest so that you can recover from the episode that brought you here.": This response dismisses the client's fear and does not address their concern about being given medications that induce sleep. It also does not acknowledge the client's right to refuse medications or address their autonomy.
B. "I will make sure that we respect your right to refuse medications.": This response validates the client's concern and reassures them that their autonomy and right to refuse medications will be respected. It promotes trust and therapeutic communication between the nurse and the client.
C. "It's not your choice to be here, so you have to accept the treatment we plan for you.": This response undermines the client's autonomy and rights, which can erode trust and impede therapeutic rapport. Involuntary admission does not negate the client's right to participate in treatment decisions or refuse medications.
D. "Why do you think your provider will prescribe you medications that will make you sleep?": This response challenges the client's perception and may come across as confrontational. It does not address the client's fear or provide reassurance about their rights regarding medication administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Holding a vibrating tuning fork 1 to 2 cm from the child's ears is not a part of the Weber's test procedure. The Weber's test involves assessing lateralization of sound in cases of unilateral hearing loss. Placing the tuning fork close to the ears may interfere with the accuracy of the test.
B. Measuring the amount of time the child can hear the sound is not relevant to the Weber's test. This action does not assess lateralization of sound but rather evaluates the duration of hearing.
C. Obtaining a tympanogram reading is not necessary before initiating the Weber's test. Tympanometry is a separate test used to assess the function of the middle ear, particularly the movement of the eardrum and the conduction bones.
D. Placing a vibrating tuning fork on the top of the child's head is the correct action for performing the Weber's test. During this test, the nurse activates a tuning fork and places it on the midline of the child's head or forehead. The child is asked if they hear the sound equally in both ears or if it is louder in one ear than the other. This helps determine if there is asymmetrical hearing loss.
Correct Answer is D
Explanation
A. "I can expect my eyelids to be bruised after this procedure": Bruising of the eyelids is not a common expectation following cataract removal surgery. While mild redness or irritation may occur, significant bruising is not typical.
B. "I will see dark spots in my vision after this procedure": Seeing dark spots in vision after cataract removal surgery is not expected. The purpose of cataract surgery is to improve vision by removing the cloudy lens and replacing it with a clear artificial lens. Dark spots in vision may indicate complications such as retinal detachment, which should be promptly reported to the healthcare provider.
C. "I will receive general anesthesia for this procedure": Cataract removal surgery typically does not require general anesthesia. Instead, it is commonly performed under local anesthesia with sedation. General anesthesia is reserved for more complex or high-risk procedures. Therefore, this statement indicates a misunderstanding of the anesthesia type for cataract surgery.
D. "I know the provider will replace the lens in my eyes during this procedure": This statement indicates an accurate understanding of the cataract removal procedure. During cataract surgery, the cloudy natural lens of the eye is removed and replaced with an artificial intraocular lens (IOL) to restore vision. This is the primary goal of the surgery, and the statement reflects the client's understanding of the procedure.
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